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HomeMy WebLinkAboutTR-118-4-6 GFBoard Of Southold 'Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ISSUED TO 118-4-6 DATE: . 1-28-93 Robert Gredick Au horiza io Pursuant to the provisions of Chaoter' 615 of the Laws Of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance eh- titled "REGULATING AND THE PLACING OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopted at a meeting held on 1~.2.8 ...... 19 c~, and in consideration of the sum of $ 150:~.0 paid by of ................................................. N.Y. and subiect to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Gra~dfather permit to repair bulkhead & permit to place retaining wall landward of bulkhead. all in accordance with the detailed specifications as presented in the orig!nating application. IN WITNESS WHEREOF, The said Board of Trustees Eere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of ~e said Board as of this date. TRUSTEES John M. Bredemeyer, III, President Henry. P. Smith, Vice President Albert J. Krupski, Jr. lohn L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SUPERVISOR SCOTI' L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 COASTAL EROSION MANAGEMENT PERMIT APPLICATION TOWN WETLANDS PERMIT APPLICATION TRUSTEE LANDS PEP~IIT APPLICATION Office Use Only: Coastal Ercsion Permit Application "Wetland Permit Application Trustee Lands Permit Application --Grandfather '"Completed Apps. Date: Variance Required, Neighbors nbtified Date: SEQRA Type Coord. Review-opt.,mand. -Insp. comp./date: SEQRA Determin./date: Public Hearing/date: Findings: Permit Vote: (Y/N): Special Conditions: (also see file) Date Rec. by Office Application Fee: Application Number; SC5T4 ~1000- Project Name (If any) Date Prepared: !i~ Applicant: ~< O ~f(~ ~°0 ~O~W ~ ~Qg~ Phone Interest: (owner, consultant, lessee,etc. Owner of Property: ~9~ Ad ress Subject Property Location: (Provide LILCO Pole ~, Distance to cross Streets if not on location map) THIS IS NOT A PERMIT Yds. to be excavated: Yds. to be filled: I©~ Manner in which material will be removed or deposited: Width of canal, creek or bay fronting property: _ ~ ~ Depth at low tide: Aver. rise in tide: Distance to nearest.channel: Distance project extends beyond similar projects in area: Area zoning: Land area in acres: Is project for private or business use: Intended use of property: Describe known prior operations conducted on premises: Has any prior license or permit been issued to erec~ s~rucnures, dredge, or deposit fill on said premises: Has any license or permit ever been revoked or suspended by a Governmental Agency: ~ Project Description The project description must also include plans for reclamation of land disturbed during construction of the principle and accessory structures and underground structures (i.e., pipeline and septic system; make additional attachments if necessary). Authorization (Where the applicant is not the owner) I ~0~~ ~~t residing at _~-~q~, (Print-owner of subject property) (Mailing address-phone) do hereby authorize to apply for Coastal Erosion permit(s) from the southold Town Trustees Signature THIS IS NOT A PERMIT County of Suffolk ) State of New York ) ~Q~L~- ~- ~t~qbt~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER K~OWLEDGE AND BELIEF, AND THAT WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT[s) OR REPRESEI~TATIVE(s), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. S t GNAT, RE SWORN TO BEFORE ME THIS DAY OF ,19 NOTARY PUBLIC Suggested space for location Map THIS IS NOT A PERMIT TRUSTEES John M. Bredemever. III. President Albert J. Krupski. Jr.. Vice President Henry P. Smith John B. Tuthill William Go Albertson Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30 year Maintenance Agreement Erosion Protection Structures Chapter 37 Southold Town Code Southold Trustees as Administrator type or print name(s) the owners of record of property at: q~% (type or print street address) SC~ ~1000-~T in applying for a Coastal Erosion pe~it for an Erosion Protection Structure do hereby agree to a 30 year maintenance progr~ for a structure co,only known as a of ~Oo ~ as shown on the attached feet of length licensed survey of the as-built structure. SUPERVISOR SCOTT L. HARRIS Town Hall 53095 Main Road RO. Box 1179 Southold. New York 11971 It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and or equivalent to the original approved structure and that for any maintenance which involves more than 5% in length of this structure we are to give prior written notice to the administrator, waiting for their approval in all but true emergency situation's which would seriously endanger life, property and important coastal natural resource features such as bluffs or wetlands. We further understand that failure to maintain the structure could result in a requirement to post a bond and or have the repairs ordered as a lien against the property upon a finding by the Trustees that said lack of maintenance would risk life, property or important natural resources features including protected, rare or threatened animals and plants. Notarized Sig~dtu~e of owner of record SWORN TO BEFORE ME THIS DAY OF ,19 NOTARY PUBLIC Please submit three copies of a licensed land survey made within one year of the original construction. This maintenance agreement shall only be valid upon the final approval of the administrator. Subsequent owners may apply to the Southold Town Trustees to re-authorize this maintenance agreement. ¢=' P~ PT,'--/